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Health Plan Categories

Updated on August 4, 2022 , 109 views

What are Health Plan Categories?

Health plan categories group refers to the four different levels of health insurance plans that come with different prices and coverage options. Note that the type of plan you choose has nothing to do with the quality of care you get. Whichever plan you choose, you are supposed to pay a monthly or annual fee of the medical care and the remaining amount will be financed by the health insurance service provider. Basically, these plans are divided into four types, such as:

Health Plan Categories

  • Gold
  • Platinum
  • Silver
  • Bronze

The difference between these plans is based on the total healthcare cost the plan covers. In other words, the level you choose will help you assess the total expenses the insurance provider will finance. Now, it goes without saying that the higher the value of the plan you choose, the higher the coverage your insurance company will offer. For example, gold and platinum happen to be the most popular and valuable insurance plans. If you choose either of them, the insurance company will cover most of your medical expenses. The plans with low value, such as silver and bronze, will offer less coverage.

Platinum has the highest actuarial value of up to 90% followed by gold. Bronze, on the other hand, has the lowest actuarial value. As mentioned before, you will get the same level of medical Facility and healthcare services in each plan. This is because the plan varies by the co-payments and deductibles rather than the quality of the healthcare services.

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Which is the Best Plan?

Now, just like other insurance plans, each member is supposed to pay a monthly premium. It doesn’t matter whether or not you claim health insurance. You have to pay the premium every month to keep your plan valid. If you choose gold and platinum insurance plans, you will have to pay a higher premium. That’s because the insurance provider is willing to cover most of your medical expenses. The better the coverage your insurance company offers, the more premium they charge from you.

The health plan categories also include a catastrophic level, which is designed for people who are eligible for the Hardship Exemption. This means people who don’t have enough funds or those who are unable to buy the minimum health coverage plan due to certain reasons can opt for a catastrophic health insurance plan. It is available for both people under and above 30 years.

If someone is unable to invest in gold, silver, bronze, and platinum health coverage plans, they can purchase the catastrophic policy. Now, this plan is available for people who get the hardship exemption. Your request for a hardship exemption will be passed if you manage to meet the eligibility criteria. You can choose the Bronze insurance plan if you need the minimum coverage. You will have to pay a low premium. However, you will need to finance most of your medical expenses. Gold and platinum plans are recommended for those who need most of their medical bills and expenses covered.

All efforts have been made to ensure the information provided here is accurate. However, no guarantees are made regarding correctness of data. Please verify with scheme information document before making any investment.
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